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A Pitfall of Decompression for Severe Exophthalmos: Role of the Posterior Wall of the Maxillary Sinus-1

Sakamoto, Yoshiaki MD*; Nakajima, Hideo MD*; Tamada, Ikkei MD; Kasai, Shogo MD*; Kishi, Kazuo MD*

Journal of Craniofacial Surgery: July 2011 - Volume 22 - Issue 4 - p 1348-1350
doi: 10.1097/SCS.0b013e31821c941d
Clinical Studies

This report addresses a pitfall of decompression for severe exophthalmos. In mild cases, removal of the orbital floor is an effective treatment, but in severe cases, the results of this approach are sometimes unsatisfactory, and only decompression is necessary. In these cases, orbital decompression in 3 areas including the medial wall, the lateral wall, and the orbital floor is usually performed. A 5.0-mm mean reduction in exophthalmos is observed, but more reduction is difficult to achieve.

We considered the possibility that removal of the posterior wall of the maxillary sinus is critically important to achieving greater recovery. It is proposed that this technique is effective in creating about 10 mm of improvement for severe exophthalmos.

From the *Department of Plastic and Reconstructive Surgery, Keio University School of Medicine; and †Department of Plastic and Reconstructive Surgery, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.

Received August 22, 2010.

Accepted for publication September 30, 2010.

Address correspondence and reprint requests to Yoshiaki Sakamoto, MD, Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ward, Tokyo 160-8582, Japan; E-mail:

The authors report no conflicts of interest.

© 2011 Mutaz B. Habal, MD